Abstract
The aim of this study was to estimate the survival of Polish Burkitt lymphoma/leukemia (BL) patients diagnosed between 1999 and 2017, considering multiple covariates and periods, to reflect changes in BL treatment. We identified all BL patients registered in the Polish National Cancer Registry in 1999–2017. Observed survival (OS) was evaluated deploying the life table method. Univariate and multivariate Cox proportional hazards regression models were fit to generate hazard ratios (HR) and the corresponding 95% confidence intervals (95% CI), describing the association between exposures (sex, age at the diagnosis, year of diagnosis, and region of residence) and time-to-event (death). Two-sided log-rank test was applied to assess the significance of exposures. Overall, 937 BL cases were included in the study (654 men and 283 women). Between the periods 1999–2005 and 2015–2017, the 3-year OS changed from 56.0% (95% CI 50.4 to 62.2%) to 73.8% (68.1 to 80.0%; P < 0.001), and the 5-year OS increased from 53.8% (48.2 to 60.0%) to 73.0% (67.1 to 79.3%; P < 0.001). The death HR was significantly higher in adolescents and young adults’ (AYA) and adults’ groups than in pediatric patients (HR = 3.00, 95% CI 2.05 to 4.39, P < 0.001, for AYA; and HR = 7.30, 5.14 to 10.3, P < 0.001, for adults). During the last two decades, the survival of Polish BL patients has been systematically improving. The death hazard ratio is most significantly associated with the patients’ age at diagnosis and year of diagnosis, and not associated with sex or region of residence.
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The data analyzed in this study was obtained from the Polish Cancer Registry and is available upon reasonable request and subject to the ethical approvals in place and material transfer agreements.
References
Crombie J, LaCasce A (2021) The treatment of Burkitt lymphoma in adults. Blood 137(6):743–750
Dozzo M et al (2017) Burkitt lymphoma in adolescents and young adults: management challenges. Adolesc Health Med Ther 8:11–29
Mbulaiteye SM et al (2012) Pediatric, elderly, and emerging adult-onset peaks in Burkitt’s lymphoma incidence diagnosed in four continents, excluding Africa. Am J Hematol 87(6):573–578
Songrug T, Adler BA, Kahwash SB (2008) Burkitt’s lymphoma/leukemia in a 15-year-old male. Radiol Case Rep 3(2):179
Yang X et al (2020) A long-term retrospective study on sporadic Burkitt lymphoma in chinese population. Medicine (Baltimore) 99(5):e18438
Sandlund JT, Martin MG (2016) Non-Hodgkin lymphoma across the pediatric and adolescent and young adult age spectrum. Hematol Am Soc Hematol Educ Program 2016(1):589–597
Rodrigues-Fernandes CI et al (2020) Clinicopathological analysis of oral Burkitt’s lymphoma in pediatric patients: a systematic review. Int J Pediatr Otorhinolaryngol 134:110033
Statistics Poland - Statistical Bulletin No 6/2019. 2019; Available from: https://stat.gov.pl/en/topics/other-studies/informations-on-socio-economic-situation/statistical-bulletin-no-62019,4,102.html?pdf=1.
Cutler SJ, Ederer F (1958) Maximum utilization of the life table method in analyzing survival. J Chronic Dis 8(6):699–712
Pohar M, Stare J (2006) Relative survival analysis in R. Comput Methods Programs Biomed 81(3):272–278
Statistics Poland - life expectancy in Poland - life tables 1990 - 2019. 2021; Available from: https://stat.gov.pl/en/topics/population/life-expectancy/.
Muggeo VMR et al (2013) Estimating growth charts via nonparametric quantile regression: a practical framework with application in ecology. Environ Ecol Stat 20(4):519–531
Perkins AS, Friedberg JW (2008) Burkitt lymphoma in adults. Hematol Am Soc Hematol Educ Program 2008(1):341–348
Vandenbroucke JP et al (2007) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. PLoS Med 4(10):e297
Costa LJ et al (2013) Trends in survival of patients with Burkitt lymphoma/leukemia in the USA: an analysis of 3691 cases. Blood 121(24):4861–4866
Liu ZL et al (2019) Trends in survival of patients with stage I/II Burkitt lymphoma in the United States: A SEER database analysis. Cancer Med 8(3):874–881
Mead GM et al (2002) An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 13(8):1264–1274
Hoelzer D et al (2014) Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood 124(26):3870–3879
Gastwirt JP, Roschewski M (2018) Management of adults with Burkitt lymphoma. Clin Adv Hematol Oncol 16(12):812–822
Goldman S et al (2014) Rituximab with chemotherapy in children and adolescents with central nervous system and/or bone marrow-positive Burkitt lymphoma/leukaemia: a Children’s Oncology Group Report. Br J Haematol 167(3):394–401
Mukhtar F et al (2017) Survival predictors of Burkitt’s lymphoma in children, adults and elderly in the United States during 2000–2013. Int J Cancer 140(7):1494–1502
Mbulaiteye SM et al (2010) Trimodal age-specific incidence patterns for Burkitt lymphoma in the United States, 1973–2005. Int J Cancer 126(7):1732–1739
de-The, G., et al (1978) Epidemiological evidence for causal relationship between Epstein-Barr virus and Burkitt’s lymphoma from Ugandan prospective study. Nature 274(5673):756–61
Magrath I (2012) Epidemiology: clues to the pathogenesis of Burkitt lymphoma. Br J Haematol 156(6):744–756
Gatta G et al (2014) Childhood cancer survival in Europe 1999–2007: results of EUROCARE-5—a population-based study. Lancet Oncol 15(1):35–47
Queiroga EM et al (2008) Burkitt lymphoma in Brazil is characterized by geographically distinct clinicopathologic features. Am J Clin Pathol 130(6):946–956
Evens AM et al (2021) Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers. Blood 137(3):374–386
Goldstein JS et al (2019) Insurance status impacts overall survival in Burkitt lymphoma. Leuk Lymphoma 60(13):3225–3234
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FLCS: Study design, statistical analysis, results interpretation, manuscript writing, and scientific discussion. IMM: Results interpretation, manuscript writing, and scientific discussion. UW: Results interpretation, epidemiological data collection, and scientific discussion. JD: Results interpretation, epidemiological data collection, and scientific discussion. JW: Results interpretation and scientific discussion. All authors read and approved the final manuscript.
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Caetano dos Santos, F.L., Michalek, I.M., Wojciechowska, U. et al. Improved survival of Burkitt lymphoma/leukemia patients: observations from Poland, 1999–2020. Ann Hematol 101, 1059–1065 (2022). https://doi.org/10.1007/s00277-022-04758-2
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DOI: https://doi.org/10.1007/s00277-022-04758-2